333001 (MFD5)auuoiNG.PeQMIT %� `DEPARTMENT OF BUILDING_& SAFETY ;'-.FIELD OFFICE '
•:- PERMITNO
.33.300
-• - .� COUNTY OF RIVERSIDE . -
-
-DST--.
i�.
CONSTRUCTION ESTIMATE NO. -ELECTRICAL -FEES NO,:PLUMBINGFEES-
I ST FL...' 3�e� _
i'r • -
2ND FL..
.d<
POR ' •'
!- • V`
GAR
ARPSQ
NALC : SQ.
-'SQ
ESTIMATED CONSTRUCTION
1
SQ. FT. Q $ oZ 3/ UNITS -
- - -. r - - - - YARD SPKLR-SYSTEM' -
SQ: FT.. @
u ,. MOBILEHOMESVC BAR`SINK
SQ.,FT.. Q� ! y
' ' - - POWER OUTLET ROOF DRAINS
FT... @, DRAINAGE PIPING
FT,. @ t DRINKING FOUNTAIN
URINAL ;
FT..
VALUATION' $ pZ 3.� oZU WATER PIPING a
NOTE. Not to be used as`property tax valuation ,' SWIM POOL, PVT - FLOOR DRAIN
MECHANICAL FEES SWIM POOL, COMM WATER SOFTENER,'
;VENT5YSTE' FAN.._0'EVAP.000Li/2-8HOOD.. D.o 'SIGN. /a WASHER (Au TO11:DI5N1 '. of
(APPLIANCE,. DRYER - GARBAGE DISPOSAL
FURNACE" < ❑UNIT Q WALL Q FLOOR' �: SUSPENDED LAUNDRY TRAY
`'AIR HANDLING UNIT' _ CFM IDLPMETER .KITCHEN SINK
ABSORPTION SYSTEM' -. 0 B.T.U. TEMP USE PERMIT -SVC WATER CLOSET, Y� 000..
°COMPRESSOR /,a - - HP g2J POLE; TEMPJPERM - LAVATORY .06
;HEATING SYSTEM`/Z; FORCED- . Q GRAVITY' Pn AMPERES SERV ENT OGS SHOWER =
BOILER B.T.U. :. SO -:FT..® ¢ _ BATH TUB
SQ. FT. p ¢ % WATER HEATER
FT. RESID '(e� 1144 - SEWAGE DISPOSAL3.¢.
HOUSE SEWER'i`GASPIPING'PERMIT
rp�9;
-
FEEPERMIT'FEE j� . PERMIT FEEDBL
_; •TOTALFEES
Mo&-MM�FEE
• MICR EE' rMECK FEE PL, CK. FEE CONST. FEE •. ELECT: FEE .SMI FEg -
V 74 CJ" lepj
FEE. FEE*
'PERMIT NO.; - -SvPP Permit_
- - �,
Job Address__-SPo -Zip';
:
Owner. - '--a
Community 1 .'
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Dor
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Dist
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'Off.FC,l'yoluation.,
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rmii Fee' S
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Fee - _• Dbl E - Ff�
Fee . +: $
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$ �d
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fiction Fee..., Dbl S u`Q
Legal Description :-
-y� r <+Jt //� /
pl Fee Dist S � 7
Zone ,
.Grp
Type -
unit
Ing Fee — -Dbl E-p?�'[6 Q
Bond Amt., �.
Plan No j� =/:
Plan Checker- -
Final
%Date - % Insp
Fee- . - Y " ^�
•Const. Lender Branch -"l cerhly rhar ;in the'pvlarr r e oft ark for which this pe+mil q issued l shall
not Mploy-any,pprson in ony;monner s, o become subiW, to the workmen's com• .•
- - ,_ --Pensohon lows of Calilornio
Address - - _ City - Zip .. -:-'pw erSignaiure, -
Builder Sgnolure
Fee- - .S -
ie Fee's - E - -
' Fee' " - $ -
,Fee' -E -
Owner/Agent _.
•Teh - - _ Zip-, -
eei s- ad
Address
City Zip
A^r' 63f�L� Yi%%T2�
M.O: .N.C., Cosh C) -.0
rd by
Contractor i.�. ' -
- - - - -
Tel.
_
License q+ _
- -
'Workers
squired --
it �SSysst/tee�m, - -/ z`
T LL P ~y
Address - - ..
Cry - - . Zip •'
. Comp.
yes ❑ • no '
5 PERMIT -SHALLBECOME VOID :IF WORK IS NOT'COMMENCED WITHIN' 1,20 DAYS. CESSATION.OF, ,, verifled,by.
JR F.OR.120-DAYSSHALL ALSO CAUSE PERMIT TO BECOME VOID,
4 .. -
HEREBY AGREE --THAT -ALL WORK IN CONNECTION WITH THIS .PERMIT: WILL BE DONE IN ACCORDANCE
WI HTHCLAWS OF.RIVgSIDECOUNTY' ANDTHESTATEOFCAL IFORNIA `
- L"HEREBY CERTIFY:THAi THE-INDI_VIDUAC WHO PREPARED THE PLANS' AND SPECIFICATIONS HAS DONE
SO- IN ACCORDANCE WITH- SECTION 5541,' C)F-THE.BUSINESS AND PROFESSIONS; -CODE OF THE STATE OF
'CALIFORNIA._-
District ,
-
4.771 ®s--.- ---.- '
BUILDING PERMIT DEPARTMENT OF BUILDING & SAFETY FIELD OFFICE
COUNTY OF RIVERSIDE
CONSTRUCTION ESTIMATE. _ -.ELECTRICAL 'FEES PLUMBING FEES DST
1 ST FL.
2ND FL.
POR.
GAR.
CARP.
WALL
ESTIMATED CONSTRUCTION
SQ. FT. @ NO. NO.
SQ. FT. @
50. FT. Cal MOTOR I OR LESS H.P.
i
SQ..FT. MOTOR 5 OR LESS H.P.
SQ. FT. Cal, MOTOR 20 OR LESS H.P. DRAINAGE PIPING
SQ.FT. @ DRINKING FOUNTAIN
SQ FT @ URINAL
VALUATION $ 0 K.W. UNITS WATER PIPING
NOTE, Not to be used as property tax valuation FLOOR DRAIN
MECHANICAL. FEES WATER SOFTENER
VENT SYSTEM ❑ FAN. ❑ EVAP. COOL 0 HOOD. I SIGN WASHER (AUTO) (DISH)
APPLIANCE FTR NMSjR K.W. GARBAGE DISPOSAL
ORME0
FURNACE Q.UNIT ❑WALL ❑'FLOOR ❑SUSPENDED OUTLETS LAUNDRY TRAY i
AIR HANDLING UNIT I CFM FDCTURE OR SOCKET KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P.G: ❑ OIL CONST. SERV, ENTRANCE WATER CLOSET
COMPRESSOR HP POLE LAVATORY
APPLIANCE VENT lob AMPERES SERV. ENT. .... SHOWER i
ABSORPTION.SYSTEM 0 B.T.U. SO. FT. @ d BATH TUB
_
INCINERATOR ❑ DOMESTIC ❑ INDUS, OR COMM. SQ. FT. @ 4 WATER HEATER
_
HEATINGSYSTEM p FORCED ❑ GRAVITY SQ. FT. RESID.@ j 4 SEWAGE DISPOSAL
BOILER 0 B.T.U. SQ. 'FT. GARAGE u11/4 HOUSE SEWER
PERMIT FEE BALANCE OF MIN. FEE GAS PIPING
MOBILE NOMENOOKUP FEE 1.,A PERMIT FEE + PERMIT FEE.
2 2p6��
S
YL
OB HK. FEE MICRO FEE
F
MECH. FEE
DBL
Fl CK: IEE
CONST. FEE
.DBL,
ELECT. FEE
o�
DBL.
SMI FEE
IEE
PLUMB. FEE
DBL
F I M k I M •1 -1 1 J I A, I 'S_ O 1 N -I DIOB.
D .ss --OWNE
�%J� �js it Dwzl?' 2X
-Irl 5 SVA
73
74
USE OF BUILDING'
"Ec. seovfcx coyww6,e
F.C.
DATE
#-��.=,�
PERM N
L6696
75
M.H: HOOKUP FEE
$
commuNITY
IG /4 V�/�-
DSJT/
�"
UNITS
I ROOMS
VALUATION-
✓��
ISUPP. TO PERMIT
OFFICE
MICROFILM FEE -
MECHANICAL FEE
'f•
COPIES
DBL
$
:$
- "-
LEGAL DESCRIPTION
0 O A/
4 p / ` T4 AC w7 _04r-
SET BACK LOT SIZE ZONE--
F - S - R.
-
USE NO.
GRP -
TYPE CK BY
I'
-PLAN CHECK FEE
$
'•BOND
AMT. -
PLAN NO. PLANCHECKER
FINAL DATE_,7.3INSPECTOR-
�' `
-
CONSTRUCTION FEE
DBL
$
.NAME
OF CONST LENDER BRANCH
OFFICE
NO LENDER; INVOLVED ,
ELECTRICAL FEE'
DBL
$
ADDRESS CITY
_ -
STAT
IE
I
i
SMI FEE
$
THIS PERMIT SHALL BECOME VOID If WORK 15. NOT COMMENCED WITHIN 60 DAYS. CESSA-
TION OF WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN AC.
CORDANCE' WITH *THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO
AGREE TO.CARRY COMPENSAT1011 INSURANCE UPON MY EMPLOYEES" COMPLIANCE WITH
THE LAWS OF'THE STATE OF CALIFORNIA COVERING CONTRACTORS 15 ALSO GUARANTEED.
1 HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS
HAS DONE SO ACCORDANCE WJTH ECTION -5541 OF THE BUSINESS AND PROFESSIONS
T F CALI t� A_
R
1 fG e1.�t
FEE
$
PLUMBING FEE
DBL
$
$
TOTAL FEES OfP
y
CASH ❑ CHECK LJr MLO. O N. C, 0-
RECEIVED BY
ADDR-ESS , -
ADDRESS
SEWAGE'SYSTEM
T
-
U...
P
_
TREES REQUIRED ���'
YES
NO- — .
CITY - _ -
c �
-- INFORMATION-
-'���
- FORM 284-2081Rm 11/721 CQ�/(ti6f:
TEL. NO. - -
T"7 �''�
TEL: O. - LICENSE -
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